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Children's Health System - Alabama

Children's of Alabama
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Rubella (German Measles)

What Is Rubella?

Rubella is an infection that mostly affects the skin and lymph nodes. In kids, rubella — commonly called German measles or 3-day measles — is usually a mild illness. But the infection is dangerous for pregnant women because it can cause serious health problems in their babies.

Rubella is caused by the rubella (roo-BELL-uh) virus (not the same virus that causes measles). It spreads when people breathe in virus-infected fluid.

Before the rubella vaccine, epidemics happened every 6-9 years, usually among kids 5 to 9 years old, along with many cases of congenital rubella. Thanks to immunization, there are far fewer cases of rubella and congenital rubella.

What Are the Signs & Symptoms of Rubella?

Rubella infection may begin with 1–2 days of mild fever (99°–100°F, 37.2°–37.8°C) and swollen, tender lymph nodes, usually in the back of the neck or behind the ears. A rash then begins on the face and spreads downward. As it spreads, it usually clears on the face.

The rubella rash is often the first sign of illness that a parent notices. It can look like many other viral rashes, appearing as either pink or light red spots, which may merge to form evenly colored patches. The rash can itch and lasts up to 3 days. As the rash clears, the affected skin might shed in very fine flakes.

Other symptoms of rubella, which are more common in teens and adults, can include headache, loss of appetite, mild conjunctivitis (inflammation of the lining of the eyelids and eyeballs), a stuffy or runny nose, swollen in other parts of the body, and pain and swollen joints. Many people with rubella have few or no symptoms.

The rubella rash usually lasts 3 days. Lymph nodes may be swollen for a week or more, and joint pain can last for more than 2 weeks. Children who have rubella usually recover within 1 week, but adults may take longer.

Is Rubella Contagious?

Rubella is contagious, and passes from person to person through tiny drops of fluid from the nose and throat through sneezing and coughing. Someone also can get it by sharing food or drink with a person who's infected. People who have rubella are most contagious from 1 week before to 1 week after the rash appears. Someone who is infected but has no symptoms can still spread the virus.

The virus also can pass through a pregnant woman's bloodstream to infect her unborn child. Babies born with congenital rubella syndrome are at risk for serious problems with their growth, thinking, heart and eyes, hearing, and liver, spleen, and bone marrow. They also can shed the virus in their urine (pee) and fluid from their nose and throat for a year or more, so can pass the virus to people who aren't immunized against it.

Can Rubella Be Prevented?

The rubella vaccine protects people from the disease. Widespread immunization is the key to preventing the spread of the virus and protecting babies from the serious health problems of congenital rubella syndrome.

Most rubella infections today are in young, non-immunized adults rather than in kids. In fact, experts say that about 10% of young adults are not vaccinated against rubella, which could be dangerous for any children they might have someday.

Children usually get the vaccine at 12–15 months of age as part of the scheduled measles-mumps-rubella (MMR) immunization or measles-mumps-rubella-varicella vaccine (MMRV). Most get a second dose at 4–6 years of age. As with all immunization schedules, there are important exceptions and special circumstances. For example, a child who will travel outside the United States can get the vaccine as early as 6 months of age. Talk to your doctor to see when your child should get the vaccine.

The rubella vaccine should not be given to pregnant women or to a woman who plans to become pregnant within 1 month of getting it. If you are thinking about becoming pregnant, make sure that you're immune to rubella through a blood test or proof of immunization. If you're not immune, get the vaccine at least 1 month before you become pregnant.

Pregnant women who are not immune should avoid anyone who has the illness, then get the vaccine after their baby is born so they'll be immune during any future pregnancies.

How Is Rubella Treated?

Antibiotics can't treat rubella because they only work against bacteria, not viruses. Unless it causes other problems, rubella will get better on its own. Rubella usually is mild in kids, who often can be cared for at home. Check your child's temperature and call the doctor if the fever climbs too high.

To ease minor discomfort, you can give your child acetaminophen or ibuprofen. Never give aspirin to a child who has a viral illness, as such use is linked to a serious condition called Reye syndrome.

When Should I Call the Doctor?

Call the doctor if your child seems to be getting sicker or has symptoms that don't seem mild.

If a pregnant woman is exposed to rubella, she should contact her doctor right away.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: May 2021